What is a Hospitalist Nurse Practitioner? (Duties, Steps to Become & Salary)


Written By: Pattie TrumblePattie Trumble, MPP, MPH

Pattie Trumble is a nurse who worked in both California and New York for many years as an emergency room nurse. She holds a Bachelor’s Degree in Economics from the University of California, Berkeley, and an Associate Degree in Nursing from the Samuel Merritt Hospital School of Nursing. Read Full Bio »»
, MPP, MPH

What is a hospitalist nurse practitioner? A hospitalist nurse practitioner is an advanced practice RN who provides comprehensive care to hospitalized patients. Traditionally, acute care nurse practitioners were primarily associated with hospital settings, whereas primary care nurse practitioners were associated with community settings. Increasingly, though, there’s a role in hospitals for NPs with a background in primary care when working with patients with chronic conditions or episodic illnesses. However, some states have practice regulations in place that may limit the effectiveness of primary care NPs in hospitals. This article will provide an in-depth look at the hospitalist nurse practitioner – what they do, steps-to-become, and salary.


What Does a Hospitalist Nurse Practitioner Do? – 6 Main Duties And Responsibilities


Roughly 83 percent of hospital medicine programs in the U.S. use nurse practitioners in some capacity. Hospitalist nurse practitioners work very closely with hospitalists (physicians), co-managing patients, filling in gaps in continuity of care, and freeing physicians to see more outpatients. Hospitalist NPs often function as central points of contact, streamlining communication among physicians, ancillary medical staff, and RNs. Hospitalist nurse practitioners are also known as “certified nurse practitioners,” hence the acronym CNP. Here are six of a CNP’s primary responsibilities:

1. Assessment and diagnosis

Hospitalist nurse practitioners perform patient physical exams and review medical histories to develop preliminary diagnoses. If immediate treatment is called for, they will provide it. This includes ordering appropriate medications.


2. Ordering diagnostic tests

In states with full practice authority, hospitalist NPs can independently order and interpret bloodwork, lab tests, and other diagnostic tests if the specific institutional policies at their place of employment allow this. In states where NPs are not allowed to practice to the full extent of their training, hospitalist NPs can only order diagnostic tests under the oversight of a supervising physician.

3. Making rounds

Hospitalist nurse practitioners collaborate closely with hospital physicians and other medical professionals, joining this team on daily patient visits known as “patient rounds.” During rounds, the team checks on patient progress and develops care plans for the day.

4. Coordinating care

Hospitalist NPs are often in charge of coordinating overall patient care by sharing information about a patient’s needs and preferences with the other members of the hospital medical team, establishing accountability for aspects of care, managing medications, and making sure all pertinent information is recorded in the patient’s medical record.

5. Patient education

Patients are far more likely to adhere to treatment regimens if they understand their necessity. CNPs are often the staff members charged with explaining disease processes and treatments to patients. Hospitalist NPs are often responsible for discharge planning as well.

6. Admissions and discharges

An increasingly popular model of care used by medium-sized and smaller non-teaching hospitals involves having physicians on premises until the end of the conventional workday and then deploying CNPs from 5:00 p.m. to 7:00 a.m. to cover. CNPs cover all admissions and discharges made during those hours.


Where Do Hospitalist Nurse Practitioners Mostly Work? – Top 3 Work Settings


As their name implies, hospitalist nurse practitioners focus strictly on patients who’ve been admitted to the hospital. They do not work with outpatients or in ambulatory care settings. Of course, hospitals have many different types of units, and hospitalist NPs will have different responsibilities in each.

1. Intensive care units

CNPs are often found working with patients in hospital units that provide short-term treatment for patients with urgent or life-threatening illnesses, such as the medical intensive care unit or the cardiovascular intensive care unit.

2. Acute care units

In acute care hospital units like medical/surgical units, hospitalist NPs may be relied upon more for case management and patient education functions.

3. Specialty care units

Many CNPs specialize in a specific type of patient care, such as cardiology, neurology, or gastroenterology, and work only on units that admit those types of patients. Depending on the scope of practice policies in their state and the institutional policies of the hospital they work for, they may assume full medical responsibility for these patients’ clinical care and management.


What is the Typical Work Schedule and Work Hours of a Hospitalist NP?


Hospitals are open 24 hours a day, seven days a week, and the hours hospitalist NPs work reflect this. CNPs work 8- or 12-hour shifts that include weekends and holidays. They may also be on call during short-staffed hours.


What Education is Required To Become a Hospitalist Nurse Practitioner After High School?


Depending upon the duration of your undergraduate and graduate nursing studies, it will take you between six and 10 years to become a hospitalist nurse practitioner. The first step is to become a registered nurse, which you can do by graduating from either an associate nursing degree (ADN) program or a Bachelor of Science in Nursing (BSN) program. Master’s of Science in Nursing (MSN) and Doctor of Nursing Practice (DNP) degrees both offer nurse practitioner options. Keep in mind that most graduate nursing programs prefer to accept students who have one or two years of professional experience, and most hospitals looking for NPs to fill their hospitalist slots prefer candidates with at least five years of experience.


How Long Does It Take To Become A Hospitalist NP After High School?


Program TypeProgram Length
BSN36 to 48 Months
BSN-to-MSN (NP)12 to 24 Months
BSN-to-DNP (NP)36 to 48 Months


How Much Does It Cost To Become A Hospitalist NP After High School?


Program TypeProgram Cost
BSN$8,990 - $226,030
BSN-to-MSN (NP)$21,360 - $208,040
BSN-to-DNP (NP)$29,240 - $285,640


What Is The Step-By-Step Process Of Becoming A Hospitalist Nurse Practitioner After High School?

(The following is a step-by-step process to become a Hospitalist NP after high school.)


STEP #1: Go to nursing school

You can’t become a hospitalist NP without becoming a registered nurse first. A BSN degree takes three to four years to complete, while an ADN degree only takes one to two years. However, a BSN is a prerequisite for getting accepted into most graduate APRN programs, so if you get an associate nursing degree, you will have to make up the BSN classes at some point.


STEP #2: Pass the NCLEX-RN exam

While states vary in their RN licensing regulations, all states require RNs to pass the NCLEX-RN exam.


STEP #3: Get a job as an RN in a hospital

You’ll need to obtain a hospital position to garner hands-on experience with the care and clinical management of chronic and acute patients and to familiarize yourself with hospital bylaws, department utilization, and institutional protocols and procedures.


STEP #4: Attend a graduate nursing program to become a nurse practitioner

“Hospitalist NP” is not one of the traditional National Council of State Boards of Nursing’s advanced practice RN roles. The majority of CNPs are certified either as family practice nurse practitioners, adult-gerontologist acute care nurse practitioners, or pediatric acute care nurse practitioners.

Some controversy exists over whether nurse practitioners specializing in primary care can function successfully as hospitalist NPs. However, a 2019 American Association of Nurse Practitioners survey found that 75 percent of hospitalist NPs are certified in primary care. CNPs receive the majority of their specialized training on the job.


STEP #5: Pursue a hospitalist fellowship

See below.


STEP #6: Take continuing education courses in inpatient hospital medicine

Many continuing education opportunities exist for CNPs that emphasize the clinical management of hospitalized patients from admission to discharge. One of the best-known is the Adult Hospital Medicine Boot Camp, organized by the Society of Hospital Medicine, which is designed to provide nurse practitioners with a broad foundation in the most common scenarios and issues encountered among hospitalized adult patients.


STEP #7: Pursue specialty certification where relevant

Pursuing a subspecialty in a specific medical niche, such as cardiology, nephrology, or orthopedics, may make you more competitive in the hospitalist NP employment market.


STEP #8: Join professional organizations

Membership in professional organizations like the Society of Hospital Medicine or the American Association of Nurse Practitioners (AANP) can aid hospitalist NPs in keeping up with the rapid changes in their chosen field. These organizations hold annual conferences where you’ll have the chance to network with peers and other colleagues. They also offer continuing education classes at a discounted rate and maintain employment boards where the top positions in the field are listed.


STEP #9: Get a nurse practitioner job in a hospital

While CNPs are in high demand, it may take you as long as six months to find the hospitalist nurse practitioner position that’s right for you. NPs with extensive ICU and med-surg experience adapt most easily to the hospitalist role, but nearly all CNPs need on-the-job training. Look for a job at a hospital that understands this and is willing to ensure you are adequately prepared for your new responsibilities.


What Are The Required or Recommended Certifications For Hospitalist Nurse Practitioners?


While there are no certifications per se explicitly associated with becoming a hospitalist nurse practitioner, all hospitalist NPs should be certified in advanced cardiac life support (ACLS) and pediatric advanced life support (PALS.)


Are There Any Fellowship or Residency Programs Available For Hospitalist Nurse Practitioners?


Johns Hopkins offers a 12-month Fellowship in Hospital Medicine that will pair you in a one-to-one preceptorship with an experienced member of the hospitalist faculty, while Atrium Health offers a 10-month Fellowship in Hospital Medicine designed to develop critical thinking, diagnostic skills, and experience in managing complex adult acute care patients. Lahey Hospital and Medical Center in Massachusetts and Mayo Clinic College of Medicine and Science in Arizona both offer hospital/internal medicine/critical care fellowships as well.


What Is The Starting Salary Of A New Grad Hospitalist Nurse Practitioner?


At your first job out of school as a CNP, you can expect to earn $100,110 annually. This breaks down to $48.13 hourly, $1,925 weekly, or $8,340 monthly.

Hourly$48.13
Weekly$1,925
Monthly$8,340
Annual$100,110


What Is The Average Salary Of A Hospitalist Nurse Practitioner?


The average hospitalist nurse practitioner salary is $136,080 a year, equivalent to $65.42 an hour, $2,617 a week, or $11,340 a month. You can anticipate reaching this benchmark when you’ve been practicing as a hospitalist NP for 10 years.

Hourly$65.42
Weekly$2,617
Monthly$11,340
Annual$136,080


What Is The Salary By Level Of Experience Of A Hospitalist NP?


Seasoned CNPs make more money than their counterparts who are novices at what they do because seasoned NPs have better-developed critical thinking and hands-on skills. Thus, a CNP with only one to four years of experience will average $113,280 a year, 13 percent higher than the entry-level salary ($100,110.) CNPs with five to nine years of experience make 33 percent more than new employees ($133,720), while CNPs with 10 to 19 years of experience make 48 percent more ($148,920.) By the time you’ve spent two or more decades as a CNP, your salary will be 78 percent higher than the salaries of colleagues who are just starting out ($177,960.)

Level of ExperienceHourlyWeeklyMonthlyAnnual
Entry-Level$48.13$1,925$8,340$100,110
1-4 Years of Experience$54.46$2,178$9,440$113,280
5-9 Years of Experience$64.29$2,572$11,140$133,720
10-19 Years of Experience$71.60$2,864$12,410$148,920
20 Years or More Experience$85.56$3,422$14,830$177,960


What Is The Average Salary Of A Hospitalist NP By State?


StateHourlyWeeklyMonthlyAnnual
Alabama$56.02$2,241$9,710$116,520
Alaska$64.24$2,570$11,140$133,620
Arizona$67.50$2,700$11,700$140,390
Arkansas$57.75$2,310$10,010$120,110
California$82.25$3,290$14,260$171,080
Colorado$62.12$2,485$10,770$129,200
Connecticut$69.75$2,790$12,090$145,070
Delaware$66.75$2,670$11,570$138,850
Florida$60.95$2,438$10,570$126,780
Georgia$61.69$2,468$10,690$128,310
Hawaii$67.52$2,701$11,700$140,440
Idaho$63.42$2,537$10,990$131,910
Illinois$64.62$2,585$11,200$134,400
Indiana$62.79$2,512$10,880$130,600
Iowa$66.61$2,664$11,550$138,550
Kansas$60.73$2,429$10,530$126,320
Kentucky$56.20$2,248$9,740$116,890
Louisiana$60.42$2,417$10,470$125,680
Maine$62.60$2,504$10,850$130,200
Maryland$65.17$2,607$11,300$135,550
Massachusetts$73.33$2,933$12,710$152,520
Michigan$61.45$2,458$10,650$127,810
Minnesota$68.75$2,750$11,920$142,990
Mississippi$59.82$2,393$10,370$124,430
Missouri$59.41$2,376$10,300$123,570
Montana$63.46$2,538$11,000$132,000
Nebraska$61.96$2,478$10,740$128,870
Nevada$75.70$3,028$13,120$157,450
New Hampshire$66.57$2,663$11,540$138,460
New Jersey$73.85$2,954$12,800$153,600
New Mexico$69.64$2,786$12,070$144,850
New York$72.73$2,909$12,610$151,270
North Carolina$61.91$2,476$10,730$128,770
North Dakota$65.05$2,602$11,280$135,310
Ohio$62.56$2,503$10,840$130,130
Oklahoma$63.30$2,532$10,970$131,670
Oregon$73.80$2,952$12,790$153,510
Pennsylvania$64.89$2,596$11,250$134,980
Rhode Island$67.95$2,718$11,780$141,340
South Carolina$59.54$2,382$10,320$123,850
South Dakota$61.60$2,464$10,680$128,130
Tennessee$52.81$2,113$9,150$109,850
Texas$66.20$2,648$11,470$137,690
Utah$65.08$2,603$11,280$135,370
Vermont$64.21$2,568$11,130$133,550
Virginia$61.54$2,462$10,670$128,010
Washington$74.03$2,961$12,830$153,990
West Virginia$57.76$2,311$10,010$120,150
Wisconsin$65.34$2,614$11,330$135,910
Wyoming$62.91$2,517$10,910$130,860


What Is The Job Outlook Like For This Career?


The employment outlook for hospitalist nurse practitioners is excellent. Hospitals have discovered that shifting much of the responsibility for inpatient management from physicians to nurse practitioners not only lowers costs but also frees physicians to see many more inpatients and outpatients. The demand for CNPs is projected to increase by 45 percent by 2032.

2022-32
+44.54%


Useful Organizations And Associations

1. Society of Hospital Medicine (SHM)

2. American Association of Nurse Practitioners (AANP)



My Final Thoughts


You’re not alone if you’ve ever wondered, “What is a hospitalist nurse practitioner?” This NP role is a relatively new one, and hospitals are still working out how best to deploy CNPs. As you can tell from reading this article about the hospitalist nurse practitioner – what do they do, steps-to-become, and salary, the position is both rewarding and highly demanding. In addition to in-depth knowledge of acute and chronic medical conditions, you’ll need to know how to navigate the complicated world of hospital protocols and operations. Be prepared to be constantly busy from the beginning to the end of your shift each day! Best way to find out if this could be the career for you? Volunteer to help out on a busy med/surg unit at your local hospital.


Frequently Asked Questions Answered


1. On Average, How Much Does A Hospitalist NP Make Per Hour?

The average salary of a Hospitalist nurse practitioner per hour is $65.42.

$65.42


2. On Average, How Much Does A Hospitalist NP Make Per Week?

The average salary of a Hospitalist nurse practitioner per week is $2,617.

$2,617


3. On Average, How Much Does A Hospitalist NP Make Per Month?

The average salary of a Hospitalist nurse practitioner per month is $11,340.

$11,340


4. On Average, How Much Does A Hospitalist NP Make Per Year?

The average salary of a Hospitalist nurse practitioner per year is $136,080.

$136,080


List Of Sources Used For This Article


1. Journal of Nursing Regulation: Hiring and Credentialing of Nurse Practitioners as Hospitalists: A National Workforce Analysis: https://www.journalofnursingregulation.com/article/S2155-8256%2820%2930132-0/abstract
2. Primary care and acute care certified nurse practitioners 2013: https://www.pncb.org/sites/default/files/2017-03/AC-PC-NP-Statementfinal2013.pdf
3. Research in Nursing & Health: State-level scope of practice regulations for nurse practitioners impact work environments: Six state investigation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534177/
4. Journal of Hospital Medicine: Development of a novel hospitalist advanced practice provider assessment instrument: A pilot study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9305217/
5. Nurses as hospitalists: https://trustees.aha.org/articles/1238-nurses-as-hospitalists
6. Independent Health and Aged Care Pricing Authority: Subacute and non-acute care: https://www.ihacpa.gov.au/health-care/classification/subacute-and-non-acute-care
7. National Council of State Boards of Nursing: APRN Consensus Model: https://www.ncsbn.org/nursing-regulation/practice/aprn.page
8. Journal of the American Association of Nurse Practitioners: Characteristics and perceptions of the US nurse practitioner hospitalist workforce: https://pubmed.ncbi.nlm.nih.gov/33208607/
9. Society of Hospital Medicine: Adult Hospital Medicine Boot Camp: https://www.hospitalmedicine.org/event/nppa-boot-camp
10. Johns Hopkins Medicine: NP/PA Fellowship in Hospital Medicine: https://www.hopkinsmedicine.org/hospital-medicine/nppa-fellowship
11. Atrium Health: Center for Advanced Practice Fellowship: https://atriumhealth.org/education/center-for-advanced-practice/fellowships/hospitalist
12. Lahey Hospital and Medical Center: Hospital Medicine AP Fellowship: https://www.lahey.org/research-education/education/fellowships/hospital-medicine-ap
13. Mayo Clinic College of Medicine and Science: Nurse Practitioner/Physician Assistant Hospital Internal Medicine/Critical Care Fellowship (Arizona): https://college.mayo.edu/academics/health-sciences-education/nurse-practitionerphysician-assistant-hospital-internal-medicinecritical-care-fellowship-arizona/


Pattie Trumble, MPP, MPH
Pattie Trumble is a nurse who worked in both California and New York for many years as an emergency room nurse. She holds a Bachelor’s Degree in Economics from the University of California, Berkeley, and an Associate Degree in Nursing from the Samuel Merritt Hospital School of Nursing. After 10 years of providing direct care, she went back to school and earned concurrent Master’s degrees in both public policy and public health from the University of California, Berkeley. Thereafter, she worked for various public health agencies in California at both the community and state levels providing economic and legislative analysis.